Russian Journal of Dentistry

BACKGROUND: According to published data, the pathogenetic link between chronic periodontitis and morbid obesity (body mass index > 40 kg/m²) is mediated by gastrointestinal dysbiosis, systemic inflammation, oxidative stress, and endotoxemia. Bacterial toxins and inflammatory mediators circulating in the bloodstream of obese patients contribute to progressive destruction of periodontal tissues and reduce the effectiveness of regenerative processes during periodontitis treatment. Therapy for such patients should include measures to normalize the intestinal microbiota composition.

AIM: To evaluate the effect of conservative treatment with probiotics on periodontal tissue status and molecular biomarkers in patients with periodontitis concurrent with obesity and dysbiosis.

METHODS: The study included 70 individuals (aged 45–59 years) with chronic periodontitis, morbid obesity, and intestinal dysbiosis, divided into two equal groups. Patients in group 1 (n = 35) received, in addition to standard therapy, a complex of live Lactobacillus and/or Bifidobacterium strains (Bifilyuks, Russia) combined with a prebiotic (lactitol) and metabiotics. Patients in group 2 (n = 35) received standard periodontitis therapy consisting of ultrasonic removal of dental deposits, surface polishing, and antiseptic treatment. Treatment efficacy was assessed at 3, 6, 9, and 12 months using the Russell Periodontal Index and probing pocket depth. Additionally, cytokine and osteomarker concentrations in periodontal exudate were monitored at 3 and 6 months.

RESULTS: After treatment, both groups showed significant reductions in periodontal index scores and probing pocket depth, indicating resolution of periodontal inflammation. However, the additional use of probiotics in group 1 resulted in a more pronounced reduction in the Russell Periodontal Index compared to group 2, particularly during the first 3–9 months. Concentrations of interleukin-8, tumor necrosis factor-alpha, and cathepsin K were also significantly lower after treatment in group 1.

CONCLUSION: The use of synbiotics as part of comprehensive conservative treatment in patients with periodontitis, obesity, and dysbiosis demonstrated high anti-inflammatory efficacy, as evidenced by clinical parameters and molecular markers of inflammation and bone resorption.

BACKGROUND: One of the most difficult tasks in clear aligner treatment is maintaining anchorage during molar distalization. Traditional anchorage methods often lead to unwanted side effects in the anterior segment.

AIM: To analyze the effectiveness of maxillary molar distalization using clear aligners and to optimize this treatment protocol based on a comparative analysis of clinical results obtained with the standard protocol versus a protocol using micro-implants.

METHODS: A total of 40 patients with Class II malocclusion were examined and treated. The patients were divided into two groups: the study group (aligners + micro-implants) and the control group (aligners + Class II elastics). Results were evaluated based on cone-beam computed tomography data and superposition of 3D jaw models.

RESULTS: In the study group, bodily molar movement of 3.2 ± 0.4 mm was achieved without loss of anchorage. In the control group, incisor protrusion (average 2.3°) and distal crown tipping (tipping) of the molars were observed.

CONCLUSION: The integration of micro-implants into the aligner treatment protocol provides predictable results and minimizes dependence on patient compliance. Skeletal anchorage provides absolute anchorage, preventing undesirable incisor protrusion and ensuring bodily control of molar movement. The use of this technique increases the predictability of digital planning and reduces the dependence of treatment outcomes on patient compliance with elastic wear.

BACKGROUND: Placement of standard titanium implants into bone tissue requires sufficient bone volume. The use of a material that is a shape-memory nickel-titanium alloy opens up new possibilities in the planning and fabrication of dental implants in geriatric dentistry.

AIM: To develop and test a technological process for manufacturing individual gerostomatological implants from the shape-memory alloy using additive technologies and 3D modeling.

METHODS: The study employed 3D modeling, printing on a 3D printer from ashfree plastic, and casting from titanium nickelide. Compliance of geometric parameters (diameter, length) with specified values and the presence of the shape-memory effect were analyzed. In an in vitro laboratory study, 10 samples of nickel-titanium alloy shape-memory implants were divided into two groups (n = 5): casting using a standard technique (group 1) and casting in a gas-protected environment (group 2). Dimensional accuracy was assessed using a caliper, and preservation of the shapememory effect was evaluated through deformation and heating. Due to the absence of result variability between the groups (complete compliance with specified parameters in group 2 versus complete non-compliance in group 1), no statistical processing was applied; the analysis was descriptive and comparative in nature.

RESULTS: Precision single-phase gerostomatological shape-memory implants were developed and fabricated (n = 10). It was established that samples from group 1, cast using the standard technique, did not meet the properties of the TN-10 alloy and were prone to fracture upon deformation; they lacked the shape-memory effect. They also did not match the dimensions of the models designed and printed on the 3D printer. Samples from group 2, cast in a gasprotected environment, complied with the properties of the TN-10 alloy; the shapememory elements returned to their original configuration at a temperature of 36°C. The dimensions of the group 2 samples precisely reproduced the dimensions of the models designed and printed on the 3D printer.

CONCLUSION: The study presents important information on a new biomechanically and biochemically compatible shape-memory nickel-titanium material. Using additive technologies and 3D modeling, along with a modern casting technique, it is possible to create highly precise models of individual single-phase gerostomatological implants with the capability for bicortical fixation. Such implants are intended for use in complex clinical situations associated with severe jawbone atrophy, aiming to improve quality of life and address the medical and social challenges of geriatric dentistry.

BACKGROUND: Despite the widespread nature of tooth extraction in outpatient dental practice, current postoperative management approaches do not always prevent the development of alveolitis and pronounced inflammatory manifestations. Evidence on the clinical efficacy of combined low-intensity laser therapy and magnetic therapy in the early postoperative period remains limited and is represented by isolated studies with a low level of evidence.

AIM: To evaluate the efficacy of a physiotherapy regimen consisting of sequential application of low-intensity laser therapy and low-frequency magnetic therapy in adult patients undergoing elective tooth extraction, in comparison with standard pharmacotherapy.

METHODS: An open-label randomized controlled trial was conducted involving 60 patients aged 18–55 years undergoing elective tooth extraction. Participants were allocated to two equal groups: the intervention group (standard therapy plus three sessions of low-intensity laser therapy and low-frequency magnetic therapy) and the control group (standard therapy alone). Outcome measures included the incidence of alveolitis (primary outcome), pain intensity assessed using a visual analogue scale, edema severity measured by linear anthropometry, dynamics of local reparative processes, analgesic consumption, and adverse event recording. Follow-up was performed over 7 days post-surgery.

RESULTS: The incidence of alveolitis was 0% in the intervention group and 13.3% in the control group (p = 0.038). The intervention group demonstrated a significantly faster reduction in pain intensity from day 2 (p < 0.001) and in edema severity from day 3 (p < 0.001) compared with controls. By day 5, granulation tissue formation was observed in 73.3% of patients in the intervention group versus 26.7% in the control group (p < 0.001). Analgesic consumption was 2.5-fold lower in the intervention group (p < 0.001). No adverse events related to the physiotherapy procedures were recorded.

CONCLUSION: The application of this physiotherapy regimen following tooth extraction significantly reduces the risk of alveolitis, alleviates pain and edema, accelerates reparative processes, and decreases medication burden, supporting its clinical efficacy and safety. Trial limitations include the modest sample size and its single-center design.

This article discusses pharmaco-induced lesions of the oral mucosa in patients after kidney transplantation based on a clinical observation. The relevance of the study is due to the need for long-term immunosuppressive therapy in transplant recipients, which significantly affects the condition of the oral tissues.

Special attention is paid to early diagnosis, analysis of clinical manifestations, and characterization of the course of pathological processes under immunosuppression.

A clinical case of a 64-year-old patient with stage 5 chronic kidney disease (hypertensive nephropathy, regular hemodialysis since 2021), kidney allograft, type 2 diabetes mellitus, multinodular goiter, and cholelithiasis is presented. The patient was hospitalized in the kidney transplant department for routine evaluation and treatment adjustment (successful kidney transplantation was performed in 2023). Examination revealed an increase in serum creatinine to 290 µmol/L. Hemodialysis was initiated and an arteriovenous fistula was created.

Oral examination revealed a dull, pale pink mucosa of the cheeks, palate, tongue, and alveolar ridges with signs of insufficient moisture. Teeth 2.5, 2.6, and 1.7 were retained roots with painless percussion; the simplified oral hygiene index was 1.6 (satisfactory hygiene); the DMFT index (decayed, missing, and filled permanent teeth) was 17 (high). Pronounced oral changes were noted, including xerostomia and multiple areas of tongue desquamation accompanied by pain, hyperemia, and fibrinous deposits. These changes developed six months after kidney allotransplantation and are presumably associated with the state of immunosuppression.

Based on the clinical observation, we illustrate the diagnostic difficulties caused by the polymorphic clinical picture and similarity of symptoms to other oral mucosal diseases.

We emphasize the need for an interdisciplinary approach to the management of this patient group with mandatory involvement of a dentist.

Dental adverse effects in patients after kidney transplantation increase the risk of infectious complications and require regular monitoring, meticulous oral hygiene, and comprehensive follow-up through interdisciplinary collaboration.

Dentofacial anomalies remain among the most common conditions affecting the maxillofacial region and pose a significant medical and social concern. Despite the numerous published studies, estimates of the prevalence and distribution of different types of dentofacial anomalies vary widely, complicating the development of a comprehensive understanding of the issue and the planning of orthodontic care. This highlights the importance of conducting a systematic review and meta-analysis with quantitative and qualitative synthesis of the available evidence.

In this work, a systematic review and meta-analysis were conducted, including 68 dissertation-based studies with a total sample of 74,168 subjects. The pooled prevalence of malocclusion was 60.7% in individuals under 15 years of age and 61.1% in those aged 15 years and older. Among dentofacial anomalies, the most frequently observed conditions were tooth position anomalies (47.2%), distal occlusion (25.7%), deep bite (16.6%), crossbite (6.1%), mesial occlusion (5.0%), and open bite (5.4%). Considerable heterogeneity was observed across all studies, reflecting differences in diagnostic approaches and study population characteristics.

These results provide a basis for refining the understanding of the pattern and frequency of dentofacial anomalies among the population of different regions of the Russian Federation, as well as identifying age-related differences in their prevalence. This creates a foundation for more evidence-based planning of preventive and therapeutic measures and emphasizes the need for standardized approaches to calculations and diagnosis in accordance with current clinical guidelines.